New Clients

If you are a new client, or if you have been to PetMend+ before but have a new furry friend, please fill out this form before you come in. This will help us expedite your first visit to us! We will be able to schedule an appointment with you either by phone or email, so please get in touch with us that way. ​Please fill out one form for each pet!

Clicking Submit Will Send Form Directly To Us Via Email

Client and Pet Information

* Indicates required field

Date *

Please Check One *

New ClientCurrent Client - New Pet

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Best Contact Number *

Other Number *

Email *

Pet's Name *

Species *

CanineFelineOther

If Other, Please Specify *

Breed *

Age and/or Birthday *

Color and Markings *

Sex *

MaleFemale

Neutered or Spayed *

YesNoUnsure

Health Status *

Please list any current or past health issues, illnesses or injuries, and any medications your pet is on currently or in the past.

Vet Information *

Please list the last time your pet has been to the vet and any names of other vets they have seen. We will require medical records during your first visit with us.